Orasure Advance HIV 1/2 testing question

[TamaraPuppa]

Hi Doctor,

I recently had a rapid Orasure Advance HIV1/2 test at a local STD dpt. of health clinic. I read up on this test after  the fact and realized the phlebotomist may not have performed the test correctly. The directions say to wipe away the first drop of blood with a cotton gauze before collecting the finger stick specimen. I noticed that she did not do this. She basically pricked my index finger (which then formed a tiny light red spot of blood), then continued to apply gently pressure to produce more blood from my finger, which she collected the sample from.

My question is, would this affrect the test results? It came out negative, however this is now constantly on my mind and I'm afraid of going back for another test. I guess what I need to know, is...if the first drop of blood was not wiped off and combined with the newer blood squeezed out, would it change the accuracy of the test in any way?

Thanks for your input. FYI--this was a 6.5 week test following a low risk exposure. I had protected sex, and am scared some semen may have come into contact with a picked callus on the palm of my hand when I was checking the condom for holes at the bathroom sink.  It was not bleeding when I picked the skin off, and I'm sure it wasn't actively bleeding at the time but the skin was pretty raw and I remember feeling a sting when I was checking the condom. Could this be a risk?

Thanks again for your help!

[Edward W Hook, MD]

I am confident the result will be negative.  Take care. EWH

[TamaraPuppa]

Ok, I will retest...and make sure the phlebotomist conducts the test correctly, just so I can have peace of mind.

Thanks!

[Edward W Hook, MD]

WhiIe I suspect that the first drop is just as good, if you think about it, you'll understand why I cannot tell you if the first drop is as good as the first, particularly when the instructions say not to use the first drop.  I re-state, your risk is low. If you have doubts just get another test (after promising yourself that you'll believe the test results).  EWH

[Edward W Hook, MD]

Welcome to our Forum.  My advice is to believe your test result. Obviously I did not witness the testing process but I can tell you that without a doubt tests offered in health departments are high quality tests which are done be trained personnel who have much testing experience.  

Further I would add that the exposure you describe falls into the category of safe sex.  Condoms are highly effective for prevention of HIV and  HIV is not transmitted through surface contamination of open wounds, scrapes, irritated skin, etc  

Finally, FYI a test at 6+ weeks would detect over 95% of infections acquired 6 weeks earlier.   Thus considering your practice of safe sex and your negative test result, I would be confident that you did not get HIV through the exposure you describe.  I hope my comments are helpful to you.  EWH

[TamaraPuppa]

Hi Doc,

Would you say then that the first drop of blood would be just as good for the test than the second? Why would the instructions advise to wipe away the first drop? Sorry, I'm still a little confused about that...